The Relevance of Vitamin and Iron Deficiency in Patients with Inflammatory Bowel Diseases in Patients of the Swiss IBD Cohort.

Vitamin and iron deficiencies are common in patients with inflammatory bowel disease (IBD) as a result of chronic intestinal inflammation, increase in demand, or dietary restrictions. Here, we assessed the frequency of complications in relation to deficiency of iron, folate acid, and vitamin B12 in patients enrolled in the nationwide Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS). A total of 2666 patients were included in the study, 1558 with Crohn's disease (CD) and 1108 with ulcerative colitis (UC). Iron deficiency anemia was detected in 19.6% of CD patients and 21.6% of UC patients. In CD patients low BMI and nonsmoker status were positively associated with anemia. In both CD and UC, malabsorption syndrome, defined as failure of the GI tract to absorb 1 or more substances from the diet, was found to be significantly associated with anemia (6.2% and 3.8%, respectively) and current steroid use (40% CD, 52.7% UC). In CD patients with ileal (31.7% vs 20%) and colonic (29.9% vs 25%) disease location folate deficiency was significantly higher than in patients with ileocolonic CD or upper GI involvement. In CD patients, vitamin B12 deficiency was associated with the onset of stenosis and intestinal surgery (42.9% vs 32.8% and 46% vs 33% for patients with versus without B12 deficiency). Our data indicate that due to frequent occurrence of deficiency states, regular monitoring and substitution of vitamins and iron are mandatory and may prevent long-term intestinal and extraintestinal complications in IBD patients

Dihydrotestosterone is a predictor for mortality in males with community-acquired pneumonia: Results of a 6-year follow-up study

Background Adrenal hormone metabolite levels are altered in acute illnesses such as community-acquired pneumonia (CAP). Our aim was to investigate associations of sex and mineralocorticoid hormone metabolites with short- and long-term mortality and severity of CAP in male and female patients. Methods We prospectively followed 285 patients (60.4% male, mean age 71 years) with CAP from a previous multicenter trial. At baseline, levels of different metabolites of sex hormones and mineralocorticoids were measured by liquid chromatography coupled to tandem mass spectrometry. We calculated Cox regression models adjusted for age and comorbidities. Results All-cause mortality was 5.3% after 30 days and increased to 47.4% after 6 years. In males, high levels of dihydrotestosterone were associated with higher 6-year mortality (adjusted HR 2.84, 95%CI 1.15–6.99, p = 0.023), whereas high levels of 17-OH-progesterone were associated with lower 6-year mortality (adjusted HR 0.72, 95%CI 0.54–0.97, p = 0.029). Testosterone levels in males correlated inversely with inflammatory markers (CRP rho = − 0.39, p < 0.001; PCT rho = − 0.34, p < 0.001) and disease severity as assessed by the Pneumonia severity index (PSI) (rho = − 0.23, p = 0.003). No similar association was found for female patients. Conclusion Whereas in males with CAP, sex and mineralocorticoid hormone metabolite levels correlated with inflammation, disease severity and long-term survival, no similar association was found for females. Further study of sex and mineralocorticoid hormones in acute illness could generate predictive signatures with implementation in clinical practice.ISSN:1465-993XISSN:1465-992

A survey on wines from organic viticulture from different European countries

A survey was carried out on a thousand wines from organic viticulture from different European countries. Analytical data were collected about the most used quality control parameters (e.g. alcoholic strength, reducing sugars, total acidity and pH, volatile acidity, malic and lactic acid, free and total sulfur dioxide), as well as regarding some compounds harmful for human health, such as ochratoxin A and biogenic amines. The results collected on quality control parameters were generally in agreement with the values normally detectable for conventional wines. Total sulfur dioxide was lower than 110-120mg/L in the most of the samples and no significant correlation was found between sulfite levels and other parameters. Ochratoxin A (OTA) seemed not a generalized problem for organic wine productions: its concentration was below the European legal limit, in the 95% of the samples analyzed; nevertheless, the risk of OTA pollution seemed higher in certain southern European regions. On the other hand, biogenic amines (BA) appeared a serious problem for organic winemaking and high concentrations were found in many of the analyzed wines. They seemed connected with a bad management of malolactic fermentation, being generally associated with high pHs and volatile acidities. \ua9 2013 Elsevier Ltd